What to Expect at a First Therapy Session

Feel confident and prepared when going into an initial therapy session, and meet our expert LGBTQIA+ therapists.

November 7, 2024
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Starting therapy, whether for the first time ever or starting with a new therapist, can bring about some anxiety. You may have a fear of being judged, especially as a member of the LGBTQIA+ community, or perhaps you’re not sure what is okay to say. You may also have concerns about sharing personal information, after all, spilling your deepest secrets to a stranger is not the most comfortable thing to do.

However, the good news is that our FOLX therapists are trained to see you without judgment, and to be frank, they’ve heard it all. They are not only part of the LGBTQIA+ community, but they have extensive experience working with all kinds of folks within the community. Therapy is your space to get support, explore your identity or feelings, and feel empowered to grow and learn things about yourself. Your therapist is there to guide you and give you tools to support whatever journey you are on. Whether you need some extra help when starting gender-affirming hormone therapy, need coping skills to manage anxiety, want support going through a breakup or building a family, our therapists can provide a safe space for you to work through your feelings.

In this article, we’ll go over how to prepare for a first therapy session, what you can expect from your therapist, and we’ll share what our therapists said about the way they approach the first session. With this information, we aim to help you feel more at ease about meeting your therapist for the first time.  

Preparing for Your First Therapy Session

In preparing for your first therapy session, you’ll want to spend some time reflecting and thinking about a few things. It might be helpful to start a therapy journal where you can jot down thoughts to reference during the session. You’ll want to think about what your goals are for therapy. To help you get there, you can ask yourself the following questions:

  • What do I want to gain from therapy?
  • Why am I seeking therapy at this moment?
  • What are my goals for therapy?
  • What are my biggest fears or concerns about therapy?
  • Are there any feelings I’ve been having recently that I want to discuss or work through?
  • Have there been any major life changes I want to bring up and work through?
  • What will make me feel safe and comfortable in a therapy session?
  • What has worked or hasn’t worked in the past for me? (If you’ve been in therapy before.)

Remember, you don’t need to have an answer for everything. These questions can help you think more deeply about your reasons for wanting to go to therapy and can help you present your thoughts to your therapist.

You can also prepare any questions you might have for your therapist. As much as it is important to prepare what you want to get out of therapy, it is equally important that you find a therapist who aligns with your goals and can be someone you feel like you can open up to. Not every therapist is going to work for every person, so making sure you feel comfortable and connect with someone is crucial. You may want to ask about your therapist’s approach or what type of therapy they practice. And when in doubt, trust your gut! If it feels right, it feels right.

What to Expect at Your First Therapy Session

You will meet with your FOLX therapist via telehealth, so make sure you take the call in a comfortable, quiet place where you will not be disturbed. In your first session, your therapist will introduce themselves and tell you about their approach to therapy. They will ask you some questions to get a sense of what brought you to therapy and what your goals in therapy are. This is your time to share as much as you feel comfortable and get a sense of what it feels like to be in conversation with your therapist. 

Remember, it may take some time to warm up to someone, especially if you’re not someone who trusts easily, and that’s okay. If you don’t necessarily know what to say in a specific moment, that’s okay, too! Your therapist is an expert and will help guide you. They are there to help build mutual trust so you can feel safe in your sessions. You don’t have to share everything all at once—it’s okay to go at your own pace. 

Once you near the end of your initial session, your therapist will discuss your plan for moving forward with possible future sessions and how they can help you meet your goals. If you’re not sure if you want to continue by the end of the session, that’s okay. You may want to reflect on your first session afterwards, writing down any thoughts or questions that came up, to help you decide. It’s important to remember that you may not know after just one session—therapy is a process that can take time and the relationship with your therapist can deepen as you move forward.

The first session is just the beginning of a journey. Like any relationship or new thing, therapy can get more comfortable and rewarding with time. Explore what feels right for you, and take the time you need to process your feelings and thoughts.

Meet Our Therapists

Here at FOLX, we have amazing queer therapists who have extensive experience working with the LGBTQIA+ community. We’d love for you to get to know them a little bit! See what our therapists said when we asked them about what to expect in therapy, how to prepare for your first visit, and some advice if you’re still on the fence.

Melissa (she/her)

What can folks expect at a first therapy appointment with you?

Folks can expect a space for mutual introductions, discussions on the therapeutic process, evaluation of needs, and some goals resourcing; though, I hope each client leaves their first session feeling like they've had an opportunity and space to be seen, heard, and a bit more understood.

What should folks prepare for their first session with you?

I encourage potential therapy members to reflect on what they would like to achieve in therapy. Often, I ask members: if we could fast forward 6 weeks, what goals have we accomplished or made progress on? I'd encourage folks to also consider jotting down a shorthand list of feelings, thoughts, and/or experiences they want to share or explore. The most important thing to bring to the first session is your self and your willingness; the rest will fall into place with the right therapist.

What advice would you have for someone who is considering therapy but may be unsure or nervous?

Take a deep breath, take some notes, and know that good therapy is built upon creating an environment that fosters safety and openness. It's okay to be nervous or not know what to say—that is part of the process.

Em (they/them)

What can folks expect at a first therapy appointment with you?

The first therapy session is what's referred to as an "intake" session. In this initial session, I review the basic structure of therapy, informed consent/confidentiality, share some of my theoretical frameworks and approaches, and ask questions to get a sense of where you've been and where you're currently at as you come to therapy. This often looks like collecting some basic information about what's bringing you to therapy, what you'd like to work on, and information about your life and history that is relevant to our treatment together. If it feels like a good fit, we go ahead and schedule our next session!

What should folks prepare for their first session with you?

For our first session, come prepared with any and all questions you might have about me, or the therapy process in general. Be ready to answer questions about yourself and what is bringing you to therapy. Take some time beforehand to think about what you'd like to get out of therapy, so that we can best establish your goals together in session.

What advice would you have for someone who is considering therapy but may be unsure or nervous?

It makes sense to be nervous!! Meeting with a complete stranger and immediately sharing your most vulnerable or intimate experiences can feel really daunting. Know that you are in the "driver's seat" in therapy with me, and I will never push you past your level of comfort. Don't anticipate having to spill all your deepest, darkest secrets immediately (unless you want to!). It takes time to build up safety and trust in the therapeutic relationship, and it is my goal to always go at a pace that feels comfortable and safe for you. Therapy is very much about the "right fit" with your therapist, so often if a therapist doesn't feel like a "heck yes", it might be worth looking around for alternatives until you find someone you feel you really connect with.

Chris (he/him)

What can folks expect at a first therapy appointment with you?

In our first session, I create a welcoming safe space to explore your concerns and goals. It’s a chance for us to get to know each other, and for me to better understand your unique needs.

What should folks prepare for their first session with you?

You don’t need to prepare much—just come as you are. And be prepared to share the issue that troubles you the most. Therapy is the most effective when you are transparent and open. I also know it takes time to get there.

What advice would you have for someone who is considering therapy but may be unsure or nervous?

It’s natural to feel unsure, but therapy is a safe space where you can explore your thoughts and feelings without judgment. Taking that first step can be empowering, and you’re not expected to have it all figured out.

Mere (they/them)

What can folks expect at a first therapy appointment with you?

First I’ll share an agenda that outlines how our time will be spent, which typically includes introductions, an overview of FOLX mental health services, and reviewing important information about therapy, confidentiality, and safety. Next, I’ll focus on getting to know you, by asking questions about what brought you to therapy and what you hope to achieve. This part of our initial session is called an intake and includes questions about your physical health, as well as your mental and emotional well-being. We’ll discuss a wide range of topics such your lifestyle, significant life events, living and/or work environment, relationships, identities, and any past or current mental health concerns. My goal is to get a holistic view of who you are, your daily life, and how your past experiences have shaped you. After gathering this information, we’ll start co-creating therapy goals tailored specifically to you. Your first appointment is not just an opportunity for me to get to know you, but it’s also a chance to ask questions, get to know me, and determine if we are a good fit for one another.

What should folks prepare for their first session with you?

Take some time to reflect on your reasons for starting therapy and your goals. Are there specific changes you want to make in your life? What are the concerns, challenges, or feelings you’d like to address and talk about? Be prepared to share your personal history, including any significant life events, relationships, or experiences that have shaped who you are. Consider what it might feel like to open up in this way and discuss sensitive topics. Think about your comforts and environment. Are you doing therapy where you would typically be working? If so, think about the physical environment that allows for the most privacy and comfort. If you have a special item, like a fidget toy or a blanket, feel free to bring it along to help you feel more at ease. Just showing up is a big deal and coming as you are is enough. There’s no right or wrong way to prepare. 

What advice would you have for someone who is considering therapy but may be unsure or nervous?

Talking about yourself, your mental health, and sensitive topics can be overwhelming. Many people feel unsure about starting therapy. Reaching out for support is a big step in itself! Don’t be afraid to let me know how you’re feeling at the start of the appointment. And know it’s okay if you’re not sure if you want to keep working together. Don’t hesitate to express the desire for more time before deciding to continue with ongoing sessions. If something doesn’t feel right, listen to your gut and feel free to consider a different therapist or approach. Your comfort and safety are top priorities. Remember that therapy is a confidential and non-judgmental space, as well as a process. You have the right to share as much or as little as you feel comfortable with.

In Summary

Starting therapy is a big step, but the rewards can be well worth it. It’s natural to feel nervous or uncertain, especially when meeting and opening up to someone new. Keep in mind that therapy is a judgment-free space where you can explore your thoughts and feelings in a way that feels right for you. At FOLX, our therapists are compassionate, experienced professionals who not only hear you, but understand you. They get the unique challenges you face as part of the LGBTQIA+ community, and are here to not only support you, but cheer you on! If you’re ready to get started with an expert LGBTQIA+ therapist, start your journey here.

To learn more and see where therapy is available, check out our therapy page.

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FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, nonbinary, or another identity, you can find LGBTQ-specialized health care that helps you meet your wellness goals. Get all the benefits of becoming a FOLX member and sign up today!

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